Montazeri M, Cook D J
Department of Pharmacy, St. Joseph's Hospital, Hamilton, Ont.
Crit Care Med. 1994 Jun;22(6):1044-8. doi: 10.1097/00003246-199406000-00027.
To describe the activities of a clinical intensive care unit (ICU) pharmacist and to determine whether pharmacist-initiated consultations lead to changes in drug costs.
Prospective, 3-month study.
A 15-bed, university-affiliated, tertiary care medical-surgical ICU.
The following ICU pharmacist activities were recorded: providing drug information for physician inquiries; providing drug information for nurse inquiries; clarification of drug orders; drug accessibility information; pharmacokinetic consultation; detection and reporting of adverse drug reactions; and pharmacist-initiated therapeutic consultation leading to changes in drug therapy. When changes in drug therapy occurred, drug costs before and after the change were determined.
During 54 weekdays, 575 pharmacist interventions occurred (10.7 +/- 5.0 interventions/day). The most common interventions were pharmacist-initiated therapeutic consultations (44.7%, 257/575 of the total), and response to physician requests for drug information (39.0%, 224/575). The most resource-intensive activities were provision of physician drug information and therapeutic consultations (49.6 mins and 35.9 mins per day, respectively). On average, 1.70 hrs (102 mins) per day were spent on all interventions. Therapeutic consultations decreased (47.1%), did not change (42.0%), or increased (10.9%) drug costs for a net savings of $10,010.60 (Canadian) over 3 months, or a projected annual savings of $67,664.24, if clinical pharmacy services were extended to 7 days/wk.
Dedicated ICU pharmacists are crucial healthcare team members in a multidisciplinary ICU. In addition to substantially reducing drug costs, they provide continuity in individualized pharmacotherapeutic care, and serve an important educational function.
描述临床重症监护病房（ICU）药师的工作内容，并确定由药师发起的会诊是否会导致药物费用的变化。
前瞻性3个月研究。
一家拥有15张床位、与大学相关的三级医疗外科ICU。
记录了以下ICU药师的工作内容：为医生的询问提供药物信息；为护士的询问提供药物信息；澄清医嘱；药物可及性信息；药代动力学会诊；药物不良反应的检测与报告；以及由药师发起的导致药物治疗改变的治疗会诊。当发生药物治疗改变时，确定改变前后的药物费用。
在54个工作日期间，共发生了575次药师干预（平均每天10.7±5.0次干预）。最常见的干预是由药师发起的治疗会诊（占总数的44.7%，257/575），以及对医生药物信息请求的回应（占39.0%，224/575）。最耗费资源的活动是为医生提供药物信息和治疗会诊（分别为每天49.6分钟和35.9分钟）。所有干预平均每天花费1.70小时（102分钟）。治疗会诊使药物费用降低（47.1%）、不变（42.0%）或增加（10.9%），3个月内净节省10,010.60加元，如果临床药学服务扩展到每周7天，预计每年可节省67,664.24加元。
在多学科的ICU中，专职的ICU药师是至关重要的医疗团队成员。除了大幅降低药物费用外，他们还能提供个性化药物治疗护理的连续性，并发挥重要的教育作用。
